Development of ganglioneuroma following successful treatment for orbital rhabdomyosarcoma

A female infant presented with a left orbital embryonal rhabdomyosarcoma at the age of 3 months. She was successfully treated for this tumour with chemo- and radiotherapy. Eight years later she developed a ganglioneuroma in the same area which was treated surgically, but recurred at the age of 19. Re-examination of all of the specimens using immunohistochemistry confirmed that the initial and successive diagnoses had been correct. Two further explanations for this rare sequence of events are considered: whether the initial biopsy had been unrepresentative of the whole tumour, or whether there had indeed been two separate tumours arising in the same area. The theories of this previously undocumented occurrence are discussed further.